I stayed away from procedures. I never, ever volunteered to do anything and would always do the bare minimum to pass on every single rotation. If the procedure was to be done on a patient with a known STD or blood-borne illness, I refused to do it.

You see, it honestly wasn’t worth it for me to risk a needle stick while performing an invasive procedure on a HIV/HepC+ patient. I don’t care how low the reported risk is — the honest truth is that there is still a risk. The risk of contracting HIV from a needle stick is higher than people winning the lottery, and people win the lottery nearly every day.

I’m sure most of you guys have seen something like the following:

A 42 year old HIV+/HepC+ male with chronic alcoholism and a history of current IV drug abuse.

• Point 1: If it wasn’t for his or her poor lifestyle decisions, they probably wouldn’t be here in the first place.
• Point 2: If I wanted to take the risk of contracting whatever it is that the patient has, I sure wouldn’t do it working 14 hour days and being abused in some shitty hospital.

It just wasn’t procedures, either. I absolutely detested the OR. I hated it with every fiber of my being. My hate stemmed not only from the asshole residents and attendings that I had to spend hours with, but also from the fact that blood was most likely going to be shooting and splattering about the fucking place at some point. For example, we once had a HepC+ guy on the vascular service who needed a femoral popliteal bypass done. He was a chronic alcoholic with near end-stage liver disease, and by the looks of him had lived quite the “exciting life” at the ripe old age of somewhere in his mid-40s. I hoped to God he would leave AMA before we had to take him to the OR.

I’m just not built to take care of people who don’t take care of themselves — and those were exactly the kinds of patients seen at training institutions that take care of the indigent population.

I’m glad I got out when I did. Fuck Hippocrates, let Darwin sort ‘em out. It’s survival of the fittest.

Popularity: 44% [?]

The following is contributed by Half M.D., the author of www.halfmd.com

The two things that piss me off quicker than anything else are inefficiency and ignorance. So far, the people who run my family medicine rotation have shown both. I’ve had one setback after another in the months leading up to this clerkship. Back in January, I wrote the course director to tell him that I would be going out of town for a special conference during his rotation. He never wrote back.

So I wrote the co-director of the course and told her the same thing. She never wrote back.

Then I wrote to the secretary for this clerkship. It turns out that she had been fired and replaced. I then wrote the new secretary of the clerkship. She never wrote back.

I went to the third year coordinator for my university to ask what was going on. I should have known something was wrong when she suggested that I make a physical appearance to the family medicine office. At that time, I couldn’t figure out why no one in the department could reply to my e-mails.

I then tried calling… multiple times.

I finally got through and confirmed all the information I provided in my original e-mail. Heeding the advice of the third year coordinator, I went to the family medicine office last week to make sure that everything was intact for my clerkship. You can imagine my surprise when I discovered that the secretary denied having ever received any information from me about my absences or where I wanted to practice family med. I had saved the e-mails and pleaded, “Here’s all the information right here.” To which she replied, “You should have e-mailed me more than one time.”

Through talking to the secretary of the course coordinator, I had hoped that everything would have been figured out for this week when I finally started the clerkship. I was given the wrong phone number to my preceptor’s office. And then when I finally managed to get through to his nurse, I was given the wrong location of his office.

I showed up bright and early Monday morning ready to see patients, but found out that he had a second practice located across town. I tried calling him at his other office multiple times that morning until I finally reached him at 10:00a.m. Keep in mind that he was supposed to have arrived by 8:30. I had to drive like a madman across town to this other office just so that I could be two hours late to my first day of my clerkship.

If things continue like this for the next month, I think I’m going to punch someone before it’s all over. Today is Wednesday.

Just in case any attendings are reading this, if you ever happen to be in a position to lead medical students—especially as a clerkship director—make sure that you have a good support staff and that everything in your clerkship is well organized. There should be no reason why students are given the incorrect telephone number and address of their clerkship location. We are paying for that education after all.

Popularity: 11% [?]